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Pharm 2 > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

Right sided heart failure

Left sided heart failure

A

Blood backs up in periphery

Blood backs up in lungs

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2
Q

Nonpharmacologic treatment for heart failure

A 
Limit salt intake
Avoid alcohol
Stop smoking
Decrease saturated fat intake
Perform mild exercise
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3
Q

Lab tests for heart failure

A

ANP: 20-77
BNP: less than 100; more sensitive test

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4
Q

Digoxin action

A 
Positive inotropic: Increases myocardial contractility 
Negative chronotropic: decreases HR
Negative dromotropic 
Increase stroke volume
A-fib
A-flutter
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5
Q

Digitalis toxicity S/SX

A 
Anorexia 
Diarrhea
N/V
Bradycardia
Premature ventricular contractions
Cardiac dysrhythmias 
Headaches
Malaise
Blurred vision
Visual illusions
Confusion
Delirium
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6
Q

Antidote for digitalis toxicity

A

Digoxin immune Fab
Ovine
Digibind

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7
Q

Assessment for Digoxin

A

Medication history
Baseline pulse
1 full minute of apical pulse: if pulse less than 60 do not give
Encourage patient to eat foods high in potassium

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8
Q

Nursing interventions for digoxin

A

Monitor serum digoxin level
Monitor potassium levels (3.5-5.3)
Eat food in fresh, dried fruits

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9
Q

Route dig can be given

A

PO

IV

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10
Q

Digitalizing

A

Loading dose given

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11
Q

The medication that decreases the excretion of digoxin and may lead to toxicity is

A

Calcium Channel Blockers

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12
Q

Interventions for CHF exacerbation

A 
Restrict fluids
I&O
Low sodium diet
Daily weight
Lasix
Serum electrolytes
Monitor glucose levels
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13
Q

Common ACE inhibitors

A 
PRIL
Benazepril
Captopril
Fosinopril 
Moexipril
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14
Q

ACE inhibitor action

A 
Dilates venules and arterioles
Improved renal blood flow
Decreases blood fluid volume 
Decreases release of aldosterone 
Treats hypertension
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15
Q

Adverse effects of ACE inhibitors

A 
Constant cough
Dizziness
Fatigue
Insomnia
Hyperkalemia 
Tachycardia
Hypotension 
Angioedema
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16
Q

Important teaching points with ACE inhibitors

A 
Do not take while pregnant 
Monitor BP
Do not abruptly stop medication 
Advise pt. Not to sure salt substitutes 
Rise slowly
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17
Q

ARB’s

A

Valsartan
Candesartan
Approved for HF in patients who cannot tolerate an ACE
Treat hypertension

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18
Q

Adverse effects of ARB’s

A 
Hypotension 
Headache
Dizziness
Rash
Weakness
Cough
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19
Q

Diuretics

A

First-line drug treatment for reducing fluid volume
Loop diuretic
Thiazide diuretic
Potassium-sparing diuretic

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20
Q

Loop diuretic drugs

A

Furosemide
Bumetanide
Torsemide
Change position slowly

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21
Q

Thiazide diuretics drugs

A

Chlorthalidan
Zaroxolyn
Hyponatremia
Hypokalemia

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22
Q

Potassium-sparing diuretic drugs

A

Amiloride
Triamtrene
Spinonladone: blocks production of aldosterone; improves HR;

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23
Q

Ultimate goal with diuretics:

A

Improved circulation

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24
Q

Beta Blockers action

A 
Carvedilol
Metoprolol tartrate 
Bisoprolol
Doses should be low initially 
Beneficial effect: 1-3 months 
Decreases HR and BP
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25
Q

BIDIL

A

Combination of hydralazine (BP)
AND isosorbide dinitrate (relieve heart pain)
Treating hear failure in African Americans

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26
Q

Classic (stable) angina

A

Predictable stress or excretion

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27
Q

Unstable angina

A

Progressive severity unrelated to activity

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28
Q

Variant angina

A

Occurs during rest

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29
Q

Types of antianginal drugs

A

Nitrates: decreases workload of heart
Beta blockers
Calcium Channel blockers

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30
Q

Nitrates

A

Relieve angina

ACTION: generalized vascular and coronary vasodilation

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31
Q

Side Effects to nitrates

A 
Headache
Hypotension 
Dizziness
Weakness
Faintness
32
Q

6 ways to give nitrates

A 
Sublingual 
Topical
Buccaneers extended-release tablet 
Oral extended-release 
Aerosol spray
IV
33
Q

Calcium channel blockers actions

A 
Relax coronary artery spasm
Relax peripheral artery's 
Decreases cardiac oxygen
Decrease cardiac contractility 
Decrease afterload
Decrease peripheral resistance 
Reduce workload of heart
34
Q

Common adverse effects of CCB

A 
Flushing
Headache
Dizziness
Ankle edema
Bradycardia
AV block
35
Q

Class I of antidysrhythmic drugs

A

Sodium channel blockers
IA: slow conduction; prolongs reploarization
IB: slow; shortens repolarization
IC: prolonged with no effect on repolarization

36
Q

Class II

Beta-adrenergic Blockers

A 
Reduce calcium entry
Propranolol 
Acebutolol
Esmolol
Sotalol
37
Q

Class III

A

Prolonged repolarization

Amiodarone

38
Q

Class IV

A

Block calcium influx
Verapamil
Diltiazem

39
Q

Thiazide diuretics serum chemistry abnormalities

A 
Hypokalemia
Hypomagnesemia
Hypercalcemia
Hypochloremia 
Hyperuricemia 
Hyperglycemia 
Hyperlipidemia
40
Q

Peripheral vasodilators

A 
Light headedness 
Dizziness
Orthostatic hypotension
Tachycardia
Palpation 
Flush
GI distress
41
Q

Patient taking lasix for HF and hypertension. Most important for the nurse to assess he patient for the development of

A

Low serum potassium, sodium, magnesium, and calcium

42
Q

Which statement will the nurse include when teaching a patient about loop diuretics

A

Rise slowly from lying or sitting

43
Q

Patient with ICP. Nurse anticipate which medication administered

A

Mannitol

44
Q

Patient receiving Lasix. Most important for nurse to monitor

A

Hypokalemia

45
Q

Patient with CHF gains 5 pounds in 1 week. Most likely indicates a fluid weight gain

A

2 L

46
Q

Before administering triamterene it is most important for nurse to determine if patient is also receiving

A

Potassium chloride

47
Q

Statement about aldosterone does the nurse identify as being true

A

Is a mineralocorticoid hormone

48
Q

Patient with chronic glaucoma is most likely to relieve what

A

A carbonic anhydrase inhibitor

49
Q

Patient receiving medication for peripheral vascular disease. Which medication

A

Cilostazol

50
Q

Herb most common associated w/ intermittent claudication

A

Ginkgo Bilbao

51
Q

Nurse asses for what when patient is given nitro

A

Hypotension

52
Q

Nurse administering digoxin. Nursing interventions:

Select all that apply

A

Check apical pulse before admin
Monitors patients serum digoxin level
Instruct patient to report pulse rate less than 60

53
Q

Patient receiving digoxin. Nurse most concerned about which assessment finding

A

Heart rate 56 beats per minute

54
Q

Administered digoxin. Labatroy result nurse be most concerned about

A

Potassium 3.0

55
Q

Most effective group for variant angina

A

Calcium channel blockers

56
Q

COPD which beta blocker most effective

A

Atenolol

57
Q

Heparin and warfarin action

A

Prevent blood from clotting

58
Q

Contraindications with heparin

A

Stroke
Peptic ulcers
Blood abnormalities

59
Q

Diet with warfarin and heparin

A 
AVOID:
Green leafy veggies
Broccoli 
Soybean oil
Coffee
Tea
Cola
Excess alcohol
Garlic 
Ginger
60
Q

Side effects of alpha agonists

A

Sodium and water retention
Dry mouth
Bradycardia

61
Q

Side effects of ARBS’s

A 
Dizziness
Diarrhea
Insomnia 
Cough
Upper respiratory infection
62
Q

Side effects of bets blockers

A 
Decrease in BP
Insomnia
Depression
Nightmares
Sexual dysfunction
63
Q

When administering TPA what do you monitor?

A

Bleeding
VS
Allergic reactions
ECG

64
Q

Antidote for TPA

A

Aminocaproic acid

65
Q

Side effects of ACE

A

Irritating cough
Insomnia
Hyperkalemia
Tachycardia

66
Q

CCB side effects

A 
Flush
Headache
Dizziness
Ankle edema
Bradycardia 
AV block
67
Q

Antianginals nursing intervention

A

Orthostatic hypotension

Offer sips before giving sublingual

68
Q

Antidysrhythmics nursing interventions

A

Hypotension
Monitor ECG
PVS

69
Q

Symptoms of severe kidney impairment

A

Oliguria (less urine)

Increased BUN and Creatinine

70
Q

Assessment of diuretics

A 
VS
Weight
Urine output
Electrolytes 
Edema
71
Q

Drugs that may cause drug interaction with diuretics

A

Digoxin
Corticosteroids
Antidiabetics
Ginkgo

72
Q

Nursing interventions with diuretics

A

Monitor potassium, glucose, uric acid and cholesterol
S/SX of hypokalemia: muscle weakness, leg cramps
Weight daily
2.2lb is equivalent to 1 liter of fluids

73
Q

Teaching with diuretics

A

Take in morning
Take BP daily
Eat foods rich in potassium (fruit and veggies)

74
Q

Urine output

A

30 mL/hr

600mL/ 24 hours

75
Q

High risk for repsiratory. Depression and PCA use

A 
Basal infusion
Older than 70 years old
History of sleep apnea 
Obesity 
Upper abdominal or thoracic surgery 
History of renal, hepatic, pulmonary, cardiac
76
Q

Teaching with Anticoagulants

A 
Inform dentist
Soft toothbrush
Shave with electric razor
Encourage to not smoke
External bleeding: pressure for 5-10 minutes
77
Q

Diet with warfarin and heparin

A 
Avoid green leafy veggies
Broccoli 
Soybean oil
Coffee
Tea
Cola
Alcohol 
Garlic
Ginger

Pharm 2 (4 decks)

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